Claims Representative

EMC Insurance; Northern (KY); Hybrid; USD 47,000 - 71,000; Full time

Benefits offered by this job

Remote option

Benefits package

401(k) match

Tuition reimbursement

Job summary

EMC Insurance is hiring a Claims Representative to investigate, evaluate, and resolve low-complexity auto, casualty, and premises liability claims. You will be the primary contact for insureds and claimants, building strong relationships with clients while applying coverage analysis and liability assessments.

This role offers remote work from anywhere in the United States and requires strong investigative and negotiation skills, with a focus on timely, fair resolutions and exceptional customer

Qualifications

• Associate degree or equivalent relevant experience
• One year of claims handling or insurance experience or related experience
• Low-complexity third-party auto, casualty, and premises liability claims handling experience strongly preferred
• Bachelor's degree may be considered in lieu of the claim handling or insurance experience requirement
• AIC, INS or other insurance related certifications preferred

Responsibilities

• Investigate and evaluate low-complexity third-party auto, casualty, and premises liability claims, including coverage analysis and liability assessment.
• Initiate timely contact with insureds, claimants, witnesses, clients, and other involved parties, typically within 24 hours of claim assignment.
• Obtain statements, gather documentation, review police/fire reports, and identify subrogation or recovery opportunities.
• Establish and maintain appropriate claim reserves based on exposure and claim developments.
• Secure and review medical records, bills, invoices, receipts, and other supporting documentation for accuracy and claim evaluation.
• Prepare excess carrier notifications and escalate complex claims to leadership when additional expertise is required.
• Respond to inquiries from clients, agents, claimants, attorneys, and coworkers regarding claim status, coverage, liability, and damages.
• Draft reservation of rights and denial letters, with appropriate management approval.
• Negotiate and resolve claims within assigned authority, recommend settlements exceeding authority limits, and issue payments accordingly.
• Prepare bodily injury and property damage evaluations, settlement documentation, and ensure proper execution of releases and agreements.
• Maintain active claim diaries, adhere to client-specific handling instructions, prepare claim summaries and reports, participate in file reviews, and stay current on industry and jurisdictional developments through ongoing training.

Job description

At EMC, we’re all about working together to make an impact. As part of our team, you’ll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts-always supporting each other to do our best work. Join us, and let’s improve lives together.

This position is eligible to work from home anywhere in the US

As a Claims Representative, you'll play a key role in helping clients navigate the claims process by investigating, evaluating, and resolving low-complexity third-party auto, casualty, and premises liability claims. You'll be the primary point of contact for insureds, claimants, and clients, gathering facts, assessing coverage and liability, and delivering fair, timely claim resolutions. Working closely with experienced claims professionals, you'll develop your expertise in claim investigations, negotiations, and customer service while helping EMC deliver exceptional outcomes for its clients. Your ability to build relationships, communicate effectively, and make sound decisions will have a direct impact on customer satisfaction, claim resolution, and overall business results.

Essential Functions

• Investigate and evaluate low-complexity third-party auto, casualty, and premises liability claims, including coverage analysis and liability assessment.
• Initiate timely contact with insureds, claimants, witnesses, clients, and other involved parties, typically within 24 hours of claim assignment.
• Obtain statements, gather documentation, review police/fire reports, and identify subrogation or recovery opportunities.
• Establish and maintain appropriate claim reserves based on exposure and claim developments.
• Secure and review medical records, bills, invoices, receipts, and other supporting documentation for accuracy and claim evaluation.
• Prepare excess carrier notifications and escal complex claims to leadership when additional expertise is required.
• Respond to inquiries from clients, agents, claimants, attorneys, and coworkers regarding claim status, coverage, liability, and damages.
• Draft reservation of rights and denial letters, with appropriate management approval.
• Negotiate and resolve claims within assigned authority, recommend settlements exceeding authority limits, and issue payments accordingly.
• Prepare bodily injury and property damage evaluations, settlement documentation, and ensure proper execution of releases and agreements.
• Maintain active claim diaries, adhere to client-specific handling instructions, prepare claim summaries and reports, participate in file reviews, and stay current on industry and jurisdictional developments through ongoing training.

Education & Experience

• Associate degree or equivalent relevant experience
• One year of claims handling or insurance experience or related experience
• Low-complexity third-party auto, casualty, and premises liability claims handling experience strongly preferred
• Bachelor's degree may be considered in lieu of the claim handling or insurance experience requirement
• AIC, INS or other insurance related certifications preferred

Knowledge, Skills & Abilities

• Basic knowledge of the claims adjusting process
• Basic knowledge of insurance contracts, medical terminology and legal aspects of court procedures affecting legal liability for all lines of insurance
• Good knowledge of computers, including claims systems
• Strong organizational and written and verbal communication skills, including documentation
• Good investigative and problem-solving abilities

The hiring salary range for this position will vary based on geographic location, falling within either of the following: $46,990 - $64,911 or $51,927 - $71,385 A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs.

For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit www.emcins.com/careers.

Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws.

All of our locations are tobacco free including in company vehicles.

Why should you choose to apply for a position at EMC?

• More than 105 years of financial strength and stability
• Named a five-star insurance carrier by Insurance Business America
• Two-time recipient of the Best Practices Award of Excellence from the Independent Agents & Brokers of America
• Multiple locations recognized as Top Workplaces based solely on team member feedback
• Corporate culture that engages and empowers team members to achieve their best
• Outstanding benefits with life, medical, dental, vision and prescription drug coverage
• Competitive paid time off plan and a full day of volunteer time off annually
• Financial incentives, including a 401(k) plan match, pension plan, OneEMC bonus plan and recognition and anniversary awards
• Professional development and growth opportunities, including tuition reimbursement
• Wellness initiatives to improve team member well-being and reduce health insurance costs
• Flexibility to dress for your day and opportunities for alternative work arrangements

EMC complies with labor law requirements.

View the federal and e-verify labor law posters.

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